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Detecting Age-Related Macular Degeneration: Technologies Are Best Compared When Standardized—Reply

Detecting Age-Related Macular Degeneration: Technologies Are Best Compared When Standardized—Reply In reply We appreciate the comments by Drs Khouri, Szirth, and Fechtner and agree that standardization and reporting of parameters that affect visualization of the image are important when making comparisons of the detection of age-related macular degeneration or other retinal disease from film or digital images. They requested specifications for the monitor and how we used it to view images. We used Dell-branded 21-in models (Dell Inc, Round Rock, Tex) and a resolution of 1280 × 1024 with 32-bit color depth. We standardized monitor calibration settings using VeriLUM calibration hardware and software (IMAGE Smiths Inc, Germantown, Md). Our distance from the computer screen was 2 to 3 ft, and the angle was 90°. We did not match the luminance of the monitor to the light box used for grading the film-based images. We set our monitors to 9500 K, but our light box was a daylight-fluorescent Logan 1055 (Logan Electronics, Chicago, Ill) with an opal glass cover, modified to hold three 14-W fluorescent tubes with a Kelvin color rating of 6200° to approximate normal daylight. We also used a modified direct-current power source to eliminate flicker. We agree with their comment that these factors are relevant when grading subtle retinal pigment epithelium changes where contrast is important. However, our rationale in doing the study was to compare data from new studies (eg, the Multiethnic Study of Atherosclerosis) grading from new digital capture systems that were optimized to detect age-related macular degeneration lesions with data from ongoing epidemiological studies (eg, the Beaver Dam Eye Study) grading from color, 30°, stereoscopic film slides on a light box using standardized grading protocols. The details of display are not the only factors that require standardization and reporting; the methods used to manipulate the images digitally also need to be carefully reported. Beyond standardization of the equipment used to capture and assess the image, both the training of those obtaining the image and detecting the lesions and the grading system used to assess the presence and severity of lesions in the image are important for ensuring high-quality, reproducible results in epidemiological and clinical studies. Correspondence: Dr Klein, 610 N Walnut St, Fourth Floor WARF, Madison, WI 53726 (kleinr@epi.ophth.wisc.edu). http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Detecting Age-Related Macular Degeneration: Technologies Are Best Compared When Standardized—Reply

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Publisher
American Medical Association
Copyright
Copyright © 2005 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.123.8.1157-b
Publisher site
See Article on Publisher Site

Abstract

In reply We appreciate the comments by Drs Khouri, Szirth, and Fechtner and agree that standardization and reporting of parameters that affect visualization of the image are important when making comparisons of the detection of age-related macular degeneration or other retinal disease from film or digital images. They requested specifications for the monitor and how we used it to view images. We used Dell-branded 21-in models (Dell Inc, Round Rock, Tex) and a resolution of 1280 × 1024 with 32-bit color depth. We standardized monitor calibration settings using VeriLUM calibration hardware and software (IMAGE Smiths Inc, Germantown, Md). Our distance from the computer screen was 2 to 3 ft, and the angle was 90°. We did not match the luminance of the monitor to the light box used for grading the film-based images. We set our monitors to 9500 K, but our light box was a daylight-fluorescent Logan 1055 (Logan Electronics, Chicago, Ill) with an opal glass cover, modified to hold three 14-W fluorescent tubes with a Kelvin color rating of 6200° to approximate normal daylight. We also used a modified direct-current power source to eliminate flicker. We agree with their comment that these factors are relevant when grading subtle retinal pigment epithelium changes where contrast is important. However, our rationale in doing the study was to compare data from new studies (eg, the Multiethnic Study of Atherosclerosis) grading from new digital capture systems that were optimized to detect age-related macular degeneration lesions with data from ongoing epidemiological studies (eg, the Beaver Dam Eye Study) grading from color, 30°, stereoscopic film slides on a light box using standardized grading protocols. The details of display are not the only factors that require standardization and reporting; the methods used to manipulate the images digitally also need to be carefully reported. Beyond standardization of the equipment used to capture and assess the image, both the training of those obtaining the image and detecting the lesions and the grading system used to assess the presence and severity of lesions in the image are important for ensuring high-quality, reproducible results in epidemiological and clinical studies. Correspondence: Dr Klein, 610 N Walnut St, Fourth Floor WARF, Madison, WI 53726 (kleinr@epi.ophth.wisc.edu).

Journal

Archives of Ophthalmology – American Medical Association

Published: Aug 1, 2005

Keywords: technology,age-related macular degeneration

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